Provider Demographics
NPI:1649568726
Name:AA HOME HEALTH CARE, LLC
Entity Type:Organization
Organization Name:AA HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-905-1626
Mailing Address - Street 1:55 N POND DR STE 1
Mailing Address - Street 2:
Mailing Address - City:WALLED LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48390-3080
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:55 N POND DR STE 1
Practice Address - Street 2:
Practice Address - City:WALLED LAKE
Practice Address - State:MI
Practice Address - Zip Code:48390-3080
Practice Address - Country:US
Practice Address - Phone:248-905-1626
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-11
Last Update Date:2011-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MID6229H251E00000X, 313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility